US8118794B2 - Reduced pressure treatment system - Google Patents

Abstract

A wound treatment apparatus is provided for treating tissue damage, which comprises a fluid impermeable wound cover sealed over a site for purposes of applying a reduced pressure to the site. The apparatus also includes a cover with protrusions on its surface for purposes of monitoring pressure at the site. An absorbable matrix may be placed in the site of a wound to encourage tissue growth into the matrix. Temperature of the site may be monitored using a layer of temperature sensitive material and temperature sensors connected to an alarm and recording device. A vacuum pump supplies suction within the wound cover over the treatment site. A portable version of the wound treatment apparatus is also provided. Finally, a method for treating wounds using reduced pressure is provided.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. patent application Ser. No. 10/652,100, filed on Aug. 28, 2003, and claims the benefit of U.S. Provisional Patent Application No. 60/407,783, filed on Sep. 3, 2002, and U.S. Provisional Patent Application No. 60/430,827, filed on Dec. 4, 2002, the entirety of all three of which are hereby incorporated by reference and made a part of the present disclosure as if fully set forth herein.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to an apparatus and a method for treating a wound by applying reduced pressure to the wound. In this context, the term “wound” is to be interpreted broadly, to include any body part of a patient that may be treated using reduced pressure.

2. Description of the Related Art

The treatment of open or chronic wounds that are too large to spontaneously close or otherwise fail to heal has long been a troublesome area of medical practice. Closure of an open wound requires inward migration of surrounding epithelial and subcutaneous tissue. Some wounds, however, are sufficiently large or infected that they are unable to heal spontaneously. In such instances, a zone of stasis in which localized edema restricts the flow of blood to the epithelial and subcutaneous tissue forms near the surface of the wound. Without sufficient blood flow, the wound is unable to successfully fight bacterial infection and is accordingly unable to close spontaneously.

An initial stage of wound healing is characterized by the formation of granulation tissue which is a matrix of collagen, fibronectin, and hyaluronic acid carrying macrophages, fibroblasts, and neovasculature that forms the basis for subsequent epithelialization of the wound. Infection and poor vascularization hinder the formation of granulation tissue within wounded tissue, thereby inhibiting wound healing. It therefore becomes desirable to provide a technique for increasing blood circulation within wounded tissue to promote spontaneous healing and to reduce infection.

Another problem encountered during the treatment of wounds is the selection of an appropriate technique for wound closure during the healing process. Sutures are often used to apply force to adjacent viable tissue in order to induce the edges of a wound to migrate together and heal. However, sutures apply a closure force to only a very small percentage of the area surrounding a wound. When there is scarring, edema, or insufficient tissue, the tension produced by the sutures can become great causing excessive pressure to be exerted by the sutures upon the tissue adjacent to each suture. As a result, the adjacent tissue often becomes ischemic thereby rendering suturing of large wounds counterproductive. If the quantity or size of the sutures is increased to reduce the tension required of any single suture, the quantity of foreign material within the wound is concomitantly increased and the wound is more apt to become infected. Additionally, the size or type of a particular wound may prevent the use of sutures to promote wound closure. It therefore becomes desirable to provide an apparatus and method for closing a large wound that distributes a closure force evenly about the periphery of the wound.

Wounds resulting from ischemia, or lack of blood flow, are also often difficult to heal since decreased blood flow to a wound may inhibit normal immune reaction to fight infection. Patients that are bedridden or otherwise non-ambulatory are susceptible to such ischemic wounds as decubitus ulcers or pressure sores. Decubitus ulcers form as a result of constant compression of the skin surface and underlying tissue thus restricting circulation. Since the patient is often unable to feel the wound or to move sufficiently to relieve the pressure, such wounds can become self-perpetuating. Although it is common to treat such wounds with flaps, the conditions that initially caused the wound may also work against successful flap attachment. Wheelchair-bound paraplegics, for example, must still remain seated after treatment of pelvic pressure sores. It therefore becomes desirable to provide a treatment procedure for ischemic wounds that can be conducted in situ upon an immobile or partially mobile patient.

Other types of wounds in which ischemia leads to progressive deterioration include partial thickness burns. A partial thickness burn is a burn in which the cell death due to thermal trauma does not extend below the deepest epidermal structures such as hair follicles, sweat glands, or sebaceous glands. The progression of partial thickness burns to deeper burns is a major problem in burn therapy. The ability to control or diminish the depth of burns greatly enhances the prognosis for burn patients and decreases morbidity resulting from burns. Partial thickness burns are formed of a zone of coagulation, which encompasses tissue killed by thermal injury, and a zone of stasis. The zone of stasis is a layer of tissue immediately beneath the zone of coagulation. Cells within the zone of stasis are viable, but the blood flow is static because of collapse of vascular structures due to localized edema. Unless blood flow is re-established within the zone of stasis soon after injury, the tissue within the zone of stasis also dies. The death of tissue within the zone of stasis is caused by lack of oxygen and nutrients, reperfusion injury (re-establishment of blood flow after prolonged ischemia), and decreased migration of white blood cells to the zone resulting in bacterial proliferation. Again, it becomes desirable to provide a technique for treating burn wounds by enhancing blood circulation to the wounded tissue to inhibit burn penetration.

There exist various apparatus utilizing reduced pressure for treatment of these types of wounds. See, for example, U.S. Pat. No. 5,636,643. The apparatus existing in the art is generally comprised of a fluid impermeable cover that covers the wound, which is directly or indirectly connected to a source of suction so that an area of reduced pressure is created beneath the cover in the area of the wound. Some type of packing material, such as gauze, is also often placed in the area of the wound beneath the cover to prevent overgrowth of the wound. Apparatus existing in the relevant art, however, suffer from several disadvantages.

One such disadvantage is the necessity to change the packing material placed in the wound during the period of treatment. This requirement is expensive because multiple dressings are necessary and medical staff must expend time to change the dressings. In addition, there is an increased risk of infection and intrusion of other harmful foreign material into the wound area. It is therefore desirable to have a reduced pressure wound treatment system having a dressing that does not need to be changed, or needs to be changed fewer times, during the period of treatment.

In addition, the existing apparatus do not have adequate means to monitor the pressure in the area of the wound beneath the cover. If the cover is not adequately sealed to the tissue surrounding the wound, reduced pressure cannot be maintained beneath the cover so that the benefits of the treatment are lost or diminished. In addition, pressure leaks through the seal cause the source of suction to operate more frequently, which consumes more energy and causes the suction equipment to wear faster than it would otherwise, reducing its useful life. Further, the flow of air into the wound area as a result of such leaks can result in increased risk of infection and intrusion of other harmful foreign material into the wound area. It is therefore desirable to have a relatively inexpensive means of monitoring the pressure level beneath the cover at the site of the wound.

In addition, the existing apparatus do not have a means to determine the amount of blood flow to the tissue at the site of the wound. As discussed above, adequate blood circulation in the area of the wound is essential for the healing process to proceed as desired. Areas of tissue having an increased level of blood circulation generally have a higher temperature than areas that have a comparatively lower level of blood circulation. It is therefore desirable to have a means of monitoring the relative temperature within the area of the wound.

Finally, it is sometimes necessary to transport patients in need of reduced pressure wound care. It is also sometimes necessary to provide reduced pressure treatment in the field. It is therefore also desirable to have a wound treatment apparatus that is portable and self-contained, which can accompany the patient during such transport or be used to provide reduced pressure treatment in the field.

SUMMARY

The present invention is directed to a reduced pressure wound treatment apparatus and method that satisfy the needs described above. As described in greater detail below, it has many advantages over existing apparatus when used for its intended purpose, as well as novel features that result in a new reduced pressure wound treatment apparatus and method that are not anticipated, rendered obvious, suggested, or even implied by any of the prior art apparatuses, either alone or in any combination thereof.

In accordance with the present invention a wound treatment apparatus is provided for treating a wound by applying reduced pressure (i.e. pressure that is below ambient atmospheric pressure) to the wound in a controlled manner for a selected time period in a manner that overcomes the disadvantages of currently existing apparatus. The application of reduced pressure to a wound provides such benefits as faster healing, increased formation of granulation tissue, closure of chronic open wounds, reduction of bacterial density within wounds, inhibition of burn penetration, and enhancement of flap and graft attachment. Wounds that have exhibited positive response to treatment by the application of negative pressure include infected open wounds, decubitus ulcers, dehisced incisions, partial thickness burns, and various lesions to which flaps or grafts have been attached.

The wound treatment apparatus in accordance with the present invention includes a reduced pressure application appliance that is applied to a treatment site at which there is a wound and normal tissue surrounding the wound. The reduced pressure application appliance includes a fluid impermeable wound cover for covering and enclosing the wound. In a particular embodiment of the present invention, the wound cover also includes means for visually monitoring the pressure in the area of the site of the wound beneath the wound cover. These means include a plurality of protrusions on the surface of the cover that are recessed when a predetermined pressure is present beneath the cover, but are increasingly displaced above the remaining surface of the cover as the pressure beneath the cover increases above a predetermined pressure. In a similar manner, the cover may contain areas that are displaced as protrusions away from the remaining surface of the cover toward the wound when reduced pressure is applied beneath the cover, and the displacement of the protrusions decreases as the pressure beneath the cover increases. The protrusions may also be a different color (or a different shade of the same color) from that on the remaining surface of the cover. In addition, the protrusions may produce a noise as they are displaced away from the remaining surface of the cover, providing an audible indication that the pressure beneath the cover is increasing.

The appliance also includes sealing means for sealing the wound cover to the surrounding tissue of the wound in order to maintain reduced pressure in the vicinity of the wound during wound treatment. When the wound cover is sealed in position over the wound site, a generally fluid-tight or gas-tight sealed enclosure is formed over the wound site. The sealing means may be in the form of an adhesive applied to the underside of the wound cover for sealing the wound cover around the periphery of the wound. The sealing means may also include a separate sealing member such as an adhesive strip or a sealing ring in the form of a tubular pad or inflatable cuff secured to the wound cover for positioning around the periphery of the wound. In selected embodiments, the reduced pressure within the sealed enclosure under the wound cover may serve to seal the wound cover in position at the wound site. The reduced pressure appliance also includes a suction port for supplying reduced pressure within the sealed volume enclosed beneath the wound cover. The suction port may be in the form of a nipple on the wound cover. Alternatively, the suction port may be in the form of a tube attached to the wound cover or provided as a feedthrough beneath the wound cover.

The appliance may also include an absorbable matrix for placement in the wound in order to encourage tissue in the area of the wound to grow into the matrix during treatment. The absorbable matrix is constructed of an absorbable material that is absorbed into the epithelial and subcutaneous tissue in the wound as the wound heals. The matrix may vary in thickness and rigidity, and it may be desirable to use a spongy absorbable material for the patient's comfort if the patient must lie upon the appliance during treatment. The matrix may also be perforated and constructed in a sponge-type or foam-type structure to enhance gas flow and to reduce the weight of the matrix. Because of the absorbable nature of the absorbable matrix, the matrix should require less frequent changing than other dressing types during the treatment process. In other circumstances, the matrix may not need to be changed at all during the treatment process.

A vacuum system is connected with the reduced pressure appliance in order to provide suction or reduced pressure to the appliance. For this purpose, the vacuum system includes a suction pump or suction device for connection with the suction port of the appliance for producing the reduced pressure over the wound site. The vacuum system may include a section of hose or tube, such as a vacuum hose, that interconnects the suction device with the suction port of the appliance to provide the reduced pressure at the wound site. A fluid collection system may be provided intermediate the vacuum hose of the suction device and the suction port of the appliance to trap any exudate that may be aspirated from the wound by the negative pressure appliance. A stop mechanism may also be provided for the vacuum system to halt production of the reduced pressure at the wound site in the event that an excessive quantity of exudate has been collected. The apparatus may also include a control device for controlling the pump.

In a particular embodiment of the invention, the wound cover for the reduced pressure appliance may be in the form of a gas impermeable covering sheet of flexible polymer material, such as polyethylene, having an adhesive backing that provides the seal for securing the sheet over the wound site to provide a gas-tight or fluid-tight sealed enclosure over the wound site. The vacuum system of the wound treatment apparatus may include a suction pump having a vacuum hose that is connected with a suction tube serving as a suction port for the appliance. The suction tube for the appliance runs beneath the cover sheet that is sealed in position over the wound site and into the fluid-tight enclosure provided under the cover sheet. An adhesive backing on the cover sheet is used to provide a fluid-tight seal around the feedthrough for the suction tube at the wound site. Within the enclosure, the suction tube is connected with the absorbable matrix for placement in the wound. The absorbable matrix functions to more uniformly apply reduced pressure or suction over the wound site while holding the cover sheet substantially out of the wound during the application of reduced pressure at the enclosed wound site.

In another particular version of the invention, the wound treatment apparatus also includes means to monitor the temperature of the tissue in the area of the wound. In a particular embodiment of this version of the invention, a temperature sensitive layer composed of a temperature sensitive material is placed adjacent to the lower surface of the wound cover. The temperature sensitive layer changes color, or changes from one shade of a color to another shade of the same color, as the temperature of the material changes. In this embodiment of the invention, the wound cover is composed of a transparent or semi-transparent material allowing the temperature sensitive material to be observed from above the wound cover. Alternatively, the wound cover is composed of a temperature sensitive material that changes color, or changes from one shade of a color to another shade of the same color, as the temperature of the material changes. In another embodiment of this version of the invention, one or more temperature measuring devices are placed in the area of the wound. The temperature measuring devices are preferably placed adjacent to the wound tissue, but may also be placed in other locations under or above the wound cover, to monitor the temperature of said tissue. Temperature measuring devices located under the wound cover have leads that feedthrough beneath the wound cover. The leads are connected to an alarm system that produces one or more alarm signals when the temperature measured by one or more of the temperature measuring devices exceeds or is lower than a predetermined value. In another embodiment of this version of the invention, the temperature measuring devices are also connected through their respective leads and the alarm system to a temperature display or recording device that produces a display or record of the temperature in the area of the wound.

In another particular version of the invention, the wound treatment apparatus is portable and self-contained. In this version of the invention, a miniature vacuum source is used to provide suction to the reduced pressure appliance. Similarly, the fluid collection system is of the minimum size desired to collect and maintain the amount of exudate expected to be aspirated from the wound during the time of anticipated use of the portable wound treatment apparatus. A filter may also be placed in the connection between the vacuum source and the fluid collection system to avoid contamination of the source by the fluid aspirated from the wound. As a result, reduced pressure treatment of a wound can continue even if it becomes necessary to transport the patient because the apparatus can accompany a patient during the transport. The portable apparatus is not, however, limited to this use alone. It can be used in any application where a portable treatment apparatus is advantageous, such as treatment of wounds in the field.

There has thus been outlined, rather broadly, the more primary features of the present invention. There are additional features that are also included in the various embodiments of the invention that are described hereinafter and that form the subject matter of the claims appended hereto. In this respect, it is to be understood that the invention is not limited in its application to the details of construction and to the arrangements of the components set forth in the following description or illustrated in the following drawings. This invention may be embodied in the form illustrated in the accompanying drawings, but the drawings are illustrative only and changes may be made in the specific construction illustrated and described within the scope of the appended claims. The invention is capable of other embodiments and of being practiced and carried out in various ways. Also, it is to be understood that the phraseology and terminology employed herein are for the purpose of the description and should not be regarded as limiting.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing summary, as well as the following detailed description of the preferred embodiments of the present invention, will be better understood when read in conjunction with the appended drawings, in which:

FIG. 1 is a schematic elevational view of a wound treatment apparatus in accordance with a particular embodiment of the present invention in which a reduced pressure appliance, shown in partial section, includes a flexible, fluid impermeable wound cover sealed over the wound and an absorbable matrix positioned in the wound, and in which a vacuum system provides reduced pressure within the wound cover of the appliance;

FIG. 2ais a schematic sectional elevational view of the reduced pressure appliance ofFIG. 1, illustrating an absorbable matrix having three layers of absorbable material, such layers being of different absorbable materials;

FIG. 2bis a schematic sectional elevational view of the reduced pressure appliance ofFIG. 1, illustrating an absorbable matrix having generally concentric layers of absorbable material, such layers being of different absorbable materials;

FIG. 3 is a schematic sectional elevational view of a reduced pressure appliance in accordance with another embodiment of the present invention, shown in partial section, in which the reduced pressure appliance includes a rigid, fluid impermeable, cone-shaped wound cover overlying the wound site;

FIG. 4ais a schematic elevational view of a wound treatment apparatus in accordance with a particular embodiment of the present invention in which a reduced pressure appliance, shown in partial section, includes a flexible, fluid impermeable wound cover sealed over the wound and an absorbable matrix positioned in the wound, and in which a vacuum system provides reduced pressure within the wound cover of the appliance;

FIG. 4bis a sectional elevational detailed view of the shutoff mechanism portion of the collection system ofFIG. 4a;

FIG. 5ais a schematic sectional elevational view of a reduced pressure appliance in accordance with another embodiment of the present invention, shown in partial section, in which the reduced pressure appliance includes a flexible, fluid impermeable wound cover sealed over the wound, said cover having embedded within it protrusions that are displaced above the remaining surface of the cover;

FIG. 5bis a detailed perspective view of a protrusion from the reduced pressure appliance ofFIG. 5a, in the fully displaced configuration;

FIG. 5cis a schematic sectional elevational view of the reduced pressure appliance ofFIG. 5a, illustrating the cover having the protrusions in the depressed configuration when sufficient vacuum is present beneath the cover;

FIG. 5dis a detailed perspective view of a protrusion from the reduced pressure appliance ofFIG. 5a, in the fully depressed configuration;

FIG. 5eis a schematic sectional elevational view of the reduced pressure appliance ofFIG. 5a, illustrating alternative protrusions having a bellows-type of configuration;

FIG. 5fis a perspective view of the reduced pressure appliance ofFIG. 5a, illustrating a pattern of protrusions on the wound cover;

FIG. 6 is a schematic sectional elevational view of a reduced pressure appliance in accordance with another embodiment of the present invention, shown in partial section, in which the reduced pressure appliance includes a packing material or an absorbable matrix positioned in the wound, and a flexible, fluid impermeable wound cover sealed over the wound, and a layer of temperature sensitive material located between the cover and the wound;

FIG. 7 is a schematic sectional elevational view of a reduced pressure appliance in accordance with another embodiment of the present invention, shown in partial section, in which the reduced pressure appliance includes a packing material positioned in the wound, and a flexible, fluid impermeable wound cover sealed over the wound, and a plurality of temperature sensors located at and surrounding the site of the wound, and in which an alarm system and a temperature display and recording device are connected to the temperature sensors;

FIG. 8ais a perspective view of a wound treatment apparatus in accordance with another embodiment of the present invention, shown from above, in which a reduced pressure appliance, a vacuum source, a filter, and a fluid collection system are connected together as a compact and portable apparatus; and

FIG. 8bis a sectional elevational detailed view of the shutoff mechanism portion of the collection system ofFIG. 8a.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

In accordance with the present invention, a wound treatment apparatus is provided for treating a wound by application of reduced pressure (i.e., below atmospheric pressure) so that suction may be applied to awound site25 in a controlled manner for a selected period of time.FIG. 1 schematically shows one version of the wound treatment apparatus, generally designated20, which includes a reduced pressure appliance, generally designated30, for enclosing awound site25 to provide a fluid-tight or gas-tight enclosure over thewound site25 to effect treatment of awound25 with reduced or negative pressure. For the purpose of creating suction within theappliance30, theappliance30 is connected with a vacuum system, generally designated50, to provide a source of suction or reduced pressure for the sealedappliance30 at thewound site25. Intermediate theappliance30 and thevacuum system50 is a fluid collection system, generally designated70, for intercepting and retaining exudate that is aspirated from thewound site25.

FIG. 1 also illustrates one embodiment of the reducedpressure appliance30, which includes anabsorbable matrix32 that is placed within thewound25, a fluidimpermeable wound cover40, and a suction port in the form ofhollow tubing45 that connects theappliance30 to the vacuum system50 (through the collection system70) to provide reduced pressure in the area beneath thecover40 in the area of thewound25.FIG. 1 also illustrates one embodiment of anabsorbable matrix32, which is placed within thewound25.

Theabsorbable matrix32 is placed over substantially the expanse of thewound25 to encourage growth of tissue in the area of thewound25 into thematrix32 as the wound heals. The size and configuration of theabsorbable matrix32 can be adjusted to fit theindividual wound25. It can be formed from a variety of absorbable materials, preferably a material that is also porous. Thematrix32 should be constructed in a manner so that it is sufficiently porous to allow oxygen to reach thewound25. Theabsorbable matrix32 is preferably constructed of a non-toxic material that is absorbable by the epithelial and subcutaneous tissue within the area of thewound25, such as collogens derived from healthy mammals, absorbable synthetic polymers, or other materials similar to those used for absorbable dressings. An example is a dehydrating material derived from seaweed for treatment of exudating wounds. Thematrix32 may vary in thickness and rigidity, although it may be desirable to use a spongy or layered, non-woven absorbable material for the patient's comfort if the patient must lie upon theappliance30 during treatment. Thematrix32 may also be perforated and constructed in a foam-type, sponge-type, or non-woven layered structure to enhance gas flow and to reduce the weight of theappliance30. As shown inFIG. 1, thematrix32 is cut to an appropriate shape and size to fit within thewound25. Alternatively, thematrix32 may be sufficiently large to overlap the surroundingskin24. Further, thematrix32 may be of uniform thickness over its entire area, as is the case where monitoring the temperature of tissue in the area of the wound is desired as a part of the treatment process.

In another embodiment of the invention, theabsorbable matrix32 has the same features as described above and as illustrated inFIG. 1, but may also be constructed of more than one absorbable material, such material having different rates of absorption into body tissue. By preselecting the materials of thematrix32, and placing them in areas of thewound25 in which different rates of absorption are desired, it may be possible to enhance wound healing. An example of this embodiment of theabsorbable matrix32 is illustrated inFIG. 2a, where thematrix32 is composed of three layers, each layer being composed of an absorbable material different from the material in the adjacent layer. Thus, in amatrix32 of three layers having thelowest layer33 being constructed of an absorbable material, and themiddle layer34 of thematrix32 being constructed of a material having a lower rate of absorption than thelowest layer33, and the layer of thematrix32 closest to the cover40 (i.e., the highest layer35) being constructed of a material having a rate of absorption lower than the other two layers, the area of thewound25 adjacent to thelowest layer26 would be allowed to close at a faster rate than the area of thewound25 adjacent to themiddle layer27, and the area of thewound25 adjacent to thehighest layer28 would be allowed to close at a faster rate than the area of thewound25 adjacent to themiddle layer27 and thelowest layer26. This embodiment of the invention is not limited to three layers or this gradation of absorption rates. Any combination of number of layers and absorbent materials desirable for wound treatment is possible and may be preferred. For example, thematrix32 may have ahighest layer35 of absorbent material having a rate of absorption higher than the rate of absorption of themiddle layer34, whichmiddle layer34 has a higher rate of absorption than the rate of absorption of thelowest layer33. Similarly, thehighest layer35 and thelowest layer33 may have rates of absorption that are approximately equal to one another, such rate of absorption being greater or lesser than the rate of absorption of themiddle layer33.

In addition, this embodiment of thematrix32 is not limited to layers. Thematrix32 may be constructed in any configuration having materials of different absorption rates in any portion of thematrix32 that is desired to promote wound healing. For example, as illustrated inFIG. 2b, the material on theperiphery36 of thematrix32 may be constructed of material having one rate of absorption, while theinner portions37 of thematrix32 may be constructed of one of more materials having different rates of absorption. This would allow for thewound25 to close at one rate during the initial portion of the treatment period, and for thewound25 to close at different rates during later portions of the treatment period. Other configurations that are possible include having approximately opposite sides or ends of thematrix32 being constructed of a different material from the intermediate portions of thematrix32.

The fluid-impermeable wound cover40 in the embodiment of the reducedpressure appliance30 illustrated inFIG. 1 is in the form of a flexible, adhesive, fluid impermeable polymer sheet for covering and enclosing thewound25, including theabsorbable matrix32 within it, and the surroundingnormal skin24 at thewound site25. The wound cover40 includes anadhesive backing41 which functions to seal the wound cover40 to thenormal skin24 around the periphery of thewound25 to provide a generally gas-tight or fluid-tight enclosure over thewound25. Theadhesive cover sheet40 must have sufficient adhesion to form a fluid-tight or gas-tight seal42 around the periphery of thewound25 and to hold thesheet40 in sealed contact with theskin24 during the application of suction or reduced or negative pressure. The wound cover40 also provides a gas-tight seal around thetubing45 at thefeedthrough location46 where thetubing45 emerges from beneath thewound cover40. The wound cover40 is preferably formed of a fluid impermeable or gas impermeable flexible adhesive sheet such as Ioban, a product of the 3M Corporation of Minneapolis, Minn.

The reducedpressure appliance30 is not, however, limited to the configuration illustrated inFIG. 1. Theappliance30 may also have a wound cover of almost any size, shape, and configuration adapted to treat the wound. An example of this type ofcover40 is illustrated in the embodiment of theappliance30 shown inFIG. 3, which has awound cover140 comprised of a rigid, fluid impermeable, generally cone-shapedwound cover140 overlying thewound site25. Alternatively, the cover overlying the wound site may be comprised of a rigid, fluid impermeable, flat, bowl-shaped, or cup-shaped wound cover to protect the site of awound25 from impact or abrasion during treatment. The wound cover may also be comprised of a fluid impermeable, flexible cover supported by rigid support members overlying thewound site25. All of these cover types may be sealed to thenormal skin24 surrounding thewound25 by using the suction created under the cover and a soft andflexible padding material143 around the periphery of thecover140, which is in contact with theskin24. More preferably, thecover140 is sealed to theskin24 using a fluid-impermeableadhesive material141 such as an adhesive tape or an adhesive sheet that has been cut to surround and at least partially overlie the periphery of thecover140. As an additional example, the cover may be comprised of a CPR mask, which may be sealed to the skin surrounding the wound with an inflatable air cuff that is a part of the mask, with a fluid-impermeable adhesive material, or by some other fluid-impermeable means. Where thecover140 is not in contact with theabsorbable matrix32, and is therefore not exerting force adequate to keep thematrix32 in place within thewound25, a rigid or semi-rigidporous screen147 may be placed over thematrix32 and under thecover140 in a position so that the periphery ofsuch screen147 is held in place by a portion of thecover140 or theseal142 that holds thecover140 in place against theskin24. In such case, thescreen147 is of a thickness and rigidity necessary to hold thematrix32 in place within thewound25, but having a porous structure so that fluids (including gases) are able to pass through thescreen147.

Theappliance30 also includes a suction port in the form of ahollow suction tube45 that connects with thevacuum system50 to provide suction within the sealed enclosure. Thesuction tubing45 serves as a suction port for theappliance30. In the embodiment of the invention illustrated inFIG. 1, anend segment45aof thetubing45 is embedded within theabsorbable matrix32 for providing suction or reduced pressure within the enclosure provided under thewound cover40. Embedding the open end ofsegment45aoftubing45 within the interior of theabsorbable matrix32 permits theabsorbable matrix32 to function as a shield to help prevent the wound cover40 from being inadvertently sucked into sealing engagement with the open end of the tube thereby plugging thetube45 and restricting gas flow. Thetube segment45aembedded within theabsorbable matrix32 preferably has at least oneside port47 for positioning within the interior of theabsorbable matrix32 to promote substantially uniform application of reduced pressure throughout the enclosure. Positioning theside port47 oftube segment45awithin the interior of theabsorbable matrix32 permits theabsorbable matrix32 to function as a shield for the side port to thereby prevent the wound cover40 from being sucked into theside port47 and thereby restricting gas flow. The open cells of theabsorbable matrix32 facilitate gas flow throughout the enclosure. In addition, theabsorbable matrix32 functions to encourage the growth of tissue in the area of thewound25 into thematrix32 and to hold the wound cover40 generally out of contact with thewound25 during the application of suction within the enclosure.

Tubing45 andtube segment45aare sufficiently flexible to permit movement of the tubing but are sufficiently rigid to resist constriction when reduced pressure is supplied to theappliance30 or when the location of thewound25 is such that the patient must sit or lie upon thetubing45 or upon the reducedpressure appliance30. The matrix-tube assembly comprising theabsorbable matrix32 and thetube45 may be fabricated by snaking the end of thetube segment45athrough an internal passageway in theabsorbable matrix32 such as by pulling the end of thetube segment45athrough the passageway using forceps. The matrix-tube assembly32 and45 is preferably prepared prior to use under sterile conditions and then stored in an aseptic package.

As shown inFIG. 4a, thevacuum system50, which produces a source of reduced pressure or suction that is supplied to the reducedpressure appliance30, includes avacuum pump51, acontrol device52, afilter53, andtubing54 that connects thevacuum pump51 to thecollection system70. Predetermined amounts of suction or reduced pressure are produced by thevacuum pump51. Thevacuum pump51 is preferably controlled by acontrol device52 such as a switch or a timer that may be set to provide cyclic on/off operation of thevacuum pump51 according to user-selected intervals. Alternatively, thevacuum pump51 may be operated continuously without the use of a cyclical timer. Afilter53 such as micropore filter is preferably attached to the exhaust of thepump51 to prevent potentially pathogenic microbes or aerosols from being vented to atmosphere by thevacuum pump51.

As shown inFIG. 4a, a fluid collection system, generally designated70, is interconnected between thesuction pump51 and theappliance30 to remove and collect any exudate which may be aspirated from thewound25 by the reducedpressure appliance30. Theappliance30 functions to actively draw fluid or exudate from thewound25. Collection of exudate in afluid collection system70 intermediate thepump51 and theappliance30 is desirable to prevent clogging of thepump51. Thefluid collection system70 is comprised of a fluid-impermeable collection container71 and ashutoff mechanism75. Thecontainer71 may be of any size and shape capable of intercepting and retaining a predetermined amount of exudate. Many examples of such containers are available in the relevant art. The preferred container in this embodiment of the invention is illustrated in side elevation view inFIG. 4a, said container having two openings in the top of thecontainer71. Thecontainer71 includes afirst port72 at the top opening of the container for sealed connection tosuction tubing45. Thefirst port72 enables suction to be applied to the reducedpressure appliance30 through thetubing45 and also enables exudate from thewound25 covered by reducedpressure appliance30 to be drained into thecontainer71. Thecontainer71 provides a means for containing and temporarily storing the collected exudate. Asecond port73 is also provided on the top of the container to enable the application of suction from thevacuum pump51. Thesecond port73 of thecollection system70 is connected to thevacuum pump51 by avacuum line54. Thecollection system70 is sealed generally gas-tight to enable thesuction pump51 to supply suction to theappliance30 through thecollection system70.

Thecontainer71 may also include a fluid impenetrable flexible liner within its volume that is used to collect the exudate in a manner that avoids contaminating thecontainer71 with pathogenic microbes and other harmful matter present in the exudate. In such case, the flexible liner may be directly connected to thefirst port72 andsecond port73 in a manner so that no exudate comes into direct contact with thecontainer71. In this embodiment, the preferred liner is a flexible bag constructed of a polymer material, which is connected to thefirst port72.

Thevacuum system50 andcollection system70 preferably include a shutoff mechanism for halting or inhibiting the supply of the reduced pressure to theappliance30 in the event that the exudate aspirated from thewound25 exceeds a predetermined quantity. Interrupting the application of suction to theappliance30 is desirable to prevent exsanguination in the unlikely event a blood vessel ruptures under the wound cover40 during treatment. If, for example, a blood vessel ruptures in the vicinity of thewound25, a shut-off mechanism would be useful to prevent thevacuum system50 from aspirating any significant quantity of blood from the patient.

Theshutoff mechanism75 may be comprised of any means that enables thevacuum system50 to halt the supply of reduced pressure to the wound cover40 at any time that the volume of exudate from thewound25 exceeds a predetermined amount. Such means may include mechanical switches, electrical switches operably connected to thevacuum system controller52, optical, thermal or weight sensors operably connected to thevacuum system controller52, and any other means that are currently known in the relevant art or which may hereafter be discovered. Theshutoff mechanism75, as illustrated inFIG. 4b, is preferably a float valve assembly in the form of a ball76 which is held and suspended within acage77 positioned below a valve seat78 disposed within the opening at the top of the container below the second port that will float upon the exudate and will be lifted against the valve seat78 as the container fills with exudate. When the ball76 is firmly seated against the valve seat78, the float valve blocks thesecond port73 and thereby shuts off the source of suction from thevacuum system50. Other types of mechanisms may also be employed to detect the liquid level within thecontainer71 in order to arrest operation of thevacuum system50.

In another version of the invention, the wound treatment apparatus includes means to monitor the pressure beneath the wound cover40 at the site of thewound25. In one embodiment of this version of the invention, as illustrated inFIG. 5a, thewound cover40 has a plurality ofprotrusions60 in the form of hills or bumps embedded in thecover40. As illustrated inFIG. 5a, theprotrusions60 protrude above the remainingsurface43 of thecover40 when thecover40 is not in use for wound treatment. A detailed view of aprotrusion60ain this configuration is shown in perspective view inFIG. 5b. Generally, as illustrated inFIG. 5c, in some embodiments, when thecover40 is in use (i.e., sealed over thewound site25 with reduced pressure applied beneath the cover40), theprotrusions60 are displaced inwardly (or downward when thecover40 is in the orientation depicted inFIG. 5c) so that they are depressed to a level almost the same as that of the remainingsurface43 of thecover40. A detailed view of aprotrusion60bin the depressed configuration is shown in perspective view inFIG. 5d. In another embodiment, theprotrusions60care configured in the form of bellows, as shown inFIG. 5e. In this version of the invention, as the pressure beneath thecover40 decreases (i.e., the level of reduced pressure increases), the top of theprotrusion60cis displaced downward toward the level of the remainingsurface43 of thecover40. Theprotrusions60 may be placed in any location, as well as in any pattern or lack of pattern, on the surface of thecover40. An example of one possible pattern is illustrated inFIG. 5f.

Theprotrusions60 may be constructed of the same material as the remainder of thecover40, or may be constructed of a material different from the remainder of thecover40, depending upon the sensitivity of pressure monitoring desired. Similarly, theprotrusions60 may be constructed of material having the same thickness as the remainder of thecover40, or material of a different thickness, depending upon the sensitivity of pressure monitoring desired. For example, if the reduced pressure beneath thecover40 is of a relatively low level, so that the difference between the ambient atmospheric pressure above thecover40 is relatively small when compared to the reduced pressure beneath thecover40, it may be desirable to have theprotrusions60 be able to change shape with relatively small changes in pressure beneath thecover40 during the treatment period. In such case, it may be preferable to have theprotrusions60 of a thickness less than the thickness of the remaining cover material. It may also be preferable to have theprotrusions60 constructed of a material more pliable than the material of which the remainder of thecover40 is constructed. Similarly, if the reduced pressure beneath thecover40 is of a relatively high level, so that the difference between the ambient atmospheric pressure above thecover40 is relatively large when compared to the reduced pressure beneath thecover40, it may be desirable to have theprotrusions60 be able to change shape with relatively large changes in pressure beneath thecover40 during the treatment period. In such case, it may be preferable to have theprotrusions60 of a thickness more similar to the thickness of the remaining cover material. It may also be preferable to have theprotrusions60 constructed of a material that is more similar to the material of which the remainder of thecover40 is constructed in terms of pliability.

By preselecting the thickness and pliability of the material used to construct theprotrusions60, it may also be possible to monitor the pressure by partial deflections of theprotrusions60. For example, theprotrusions60 may be displaced in an increasing amount above the remainingsurface43 of thecover40 as the pressure beneath thecover40 increases (i.e., the level of reduced pressure decreases). This relationship of displacement of theprotrusions60 to the increase in pressure beneath thecover40 may be linear or based upon some other function. Similarly, theprotrusions60 may be constructed so that they only begin to be displaced when a predetermined pressure differential occurs between the area under thecover40 and the area above thecover40. It should be noted, however, that this version of the invention is intended as a means to provide an inexpensive and approximate visual indication of the occurrence of loss of reduced pressure beneath the cover and may not be a means to accurately measure the actual pressure beneath the cover or the actual difference between the pressure above the cover and the reduced pressure beneath the cover.

As a result, the preferable thicknesses and materials to be used in constructing thecover40 andprotrusions60 in this version of the invention are dependent upon a multitude of factors, including the desired pressure beneath thecover40. Preferably, thewound cover40 is constructed of polyurethane, having a thickness of only a few mils to ⅛th inch, and havingprotrusions60 constructed of the same material as the remaining portion of thecover40, saidprotrusions60 having a thickness only slightly less than the thickness of thecover40 to a relatively small fraction of the thickness of thecover40.

Further, theprotrusions60 may be constructed of material that is of a different color than the color of the remainingsurface43 of thecover40. Similarly, theprotrusions60 may be of a different shade of the same color as the remainingsurface43 of thecover40. As theprotrusions60 are displaced away from the remainingsurface43 of thecover40, theprotrusions60 may change color as a result of the expansion of the material comprising theprotrusions60.

In another embodiment of this version of the invention, the protrusions work in the manner opposite to that described above. In this embodiment, the cover has within it a plurality of areas that are displaced away (i.e., pulled down) from the remaining surface of the cover toward the wound when reduced pressure is applied beneath the cover. This downward displacement is the result of the reduced pressure suction, which causes tension that pulls the protrusions away from the remaining surface of the cover. As the pressure beneath the cover increases, the tension on the protrusions weakens allowing the protrusions to recede back into the cover. The principles discussed above with respect to thickness, materials, color, and partial deflection monitoring of pressure apply to this embodiment of the invention as well. It should be noted that bellows-type protrusions are not used in this embodiment.

Theprotrusions60 may also have a means whereby they produce an audible sound as theprotrusions60 are being displaced away from the remainingsurface43 of thecover40. This sound may be produced by the “crinkling” or vibration of the material as it is displaced away from the remainingsurface43 of thecover40.

It should be noted that the means to monitor the pressure beneath the cover described in this embodiment of the invention may be used independently of any other feature of this invention. In addition, the means to monitor pressure beneath the cover is not limited to use in treatment of open wounds, decubitus ulcers, dehisced incisions, partial thickness burns, and various lesions to which flaps or grafts have been attached. Instead, said pressure monitoring means may be used in any application involving reduced pressure in the treatment of any portion of the body of a patient, such as cosmetic surgery, cosmetic healing, and prophylactic suctioning for cosmetic and psychological reasons. In addition, the cover may be of any configuration, including the cover configurations specifically discussed above. Further, it is not necessary that any packing material or matrix be present in the area of the wound beneath the cover in this version of the invention. Nor is it necessary that the features included in this version of the invention be included as a part of any other version or embodiment of this invention.

In another version of the invention, the wound treatment apparatus includes means to monitor the temperature in the area of thewound25. In one embodiment of this second version of the invention, as illustrated inFIG. 6, a layer of temperaturesensitive material80 is placed adjacent to thelower surface44 of thewound cover40. Alternatively, thecover40 and thelayer80 may be joined together to form a single integrated unit. In such case, thecover40 and thelayer80 may be joined in any manner that is fluid-impermeable and allows the color (or other property exhibiting the change of temperature) of the temperaturesensitive layer80 to be observed from above thewound cover40. The preferred means to join thecover40 and thelayer80 is a transparent or semi-transparent adhesive material. Alternatively, thewound cover40 may itself be composed of a temperature sensitive material, so that a separate temperature sensitive layer is not required.

The temperature sensitive layer80 (or thecover40, if it is composed of a temperature sensitive material) may be composed of any material that changes properties in a manner that does not adversely affect the operation of the reducedpressure appliance30. Preferably, the temperaturesensitive layer80 is composed of a material that changes color, or changes from one shade of a color to another shade of the same color, as the temperature of the material changes. The change in color or shade preferably occurs within the temperature range that may be expected in the area of thewound25. In other words, the change in color or shade of the material should be significant enough to adequately indicate changes in temperature within the range of temperatures expected in the area of thewound25. More preferably, the temperature sensitive material is a material that changes color in the range from approximately 95 degrees Fahrenheit to approximately 105 degrees Fahrenheit.

In the embodiment of the invention shown inFIG. 6, the temperaturesensitive layer80 is placed over a packing material ormatrix32a, which packing material ormatrix32ais placed within the area of thewound25. Thematrix32amay be anabsorbable matrix32a, as described above. The packing material may be constructed of any material that is suitable for placement within awound25, which may be to prevent its overgrowth, but still allows for fluid and gas flow to and from thewound25, such as a porous polymer material or gauze. In order to provide for uniform temperature monitoring, the packing material ormatrix32ais preferably of relatively uniform thickness when placed within the area of thewound25. In addition, the packing material ormatrix32ashould be thin enough to allow for the temperature of the tissue to affect the temperature of the temperaturesensitive layer80. More preferably, the thickness of the packing material ormatrix32ashould not exceed slightly greater than zero to one half inches. The packing material ormatrix32amay, however, be of non-uniform thickness where the temperaturesensitive layer80 is comprised of temperature sensitive material in a manner that compensates for the differences in thickness of the packing material ormatrix32a.

The wound cover40 is placed over the temperaturesensitive layer80 and sealed to thenormal skin24 surrounding thewound25. If thecover40 and the temperaturesensitive layer80 are an integrated unit, however, the unit is placed over the packing material ormatrix32awithout a separate temperaturesensitive layer80. If thecover40 is composed of a temperature sensitive material, it is placed over the packing material or matrix without an additional temperaturesensitive layer80. It should be noted, however, that the temperature sensitive material used in this embodiment of the invention is intended as a means to provide an approximate visual indication of the temperature in the area of thewound25 beneath the cover4, and may not accurately measure the actual temperature beneath thecover40.

In another embodiment of this second version of the invention, one or moretemperature measuring devices81 are placed within the area of thewound25 and connected to an alarm system, generally designated as82. Thetemperature measuring devices81 may also be connected to a temperature display andrecording device83. An example of this embodiment is illustrated inFIG. 7, which showstemperature measuring devices81 placed in the area of thewound25. Thetemperature measuring devices81 may be placed in any area of thewound25 and the reducedpressure appliance30. For example, thetemperature measuring devices81 may be placed adjacent to and in direct contact with the tissue in the area of thewound25. Alternatively, thetemperature measuring devices81 may be embedded in any packing material ormatrix32 placed in the area of thewound25, or in the area between such packing material ormatrix32 and thecover40, or embedded within thecover40, or adjacent to either surface of thecover40.

Thetemperature measuring devices81 are preferably capable of measuring temperatures in the range of temperatures expected in the area of thewound25. More preferably, thetemperature measuring devices81 are capable of measuring temperatures in the range of 95 degrees Fahrenheit to 105 degrees Fahrenheit. Thetemperature measuring devices81 may be any device that measures temperature in the desired range and produces a corresponding signal that may be interpreted by thealarm system82 and temperature display andrecording device83. Thetemperature measuring devices81 must, however, not be harmful to body tissue. Thetemperature measuring devices81 are preferably thermocouples or optical sensors or detectors. Thetemperature measuring devices81 are more preferably thermocouples that generate an electronic signal representing the temperature measured by the thermocouple.

Thetemperature measuring devices81 are connected byleads84 to analarm system82. The leads84 may be in any form compatible with thetemperature measuring devices81 and thealarm system82 andrecording device83. Preferably, theleads84 are cables or wires constructed of an electrically conductive material, optical fiber, or other medium enabling data transmission that transfers the signals from thetemperature measuring devices81 to thealarm system82 and the display andrecording device83. Leads84 placed under thewound cover40 feedthrough theseal42 beneath thecover40 in a manner similar to that for the tubing (as illustrated and discussed above in connection withFIG. 1) that maintains the fluid impermeable nature of theseal42.

Thealarm system82 is comprised of a computer orother data processor85 and analarm device86. The computer ordata processor85 receives the signals from thetemperature measuring devices81 and converts them to electronic or other signals that are recognized by thealarm device86. The computer ordata processor85 is of a type that is commonly available in the relevant art. Thealarm device86 may produce any type of audible sound as an alarm, such as a ringing sound, buzzing, chirping or other common alarm noise. Alternatively, thealarm device86 may include a digitally produced audible voice that presents predetermined messages corresponding to different temperature conditions in the area of thewound25. Thealarm device86 preferably produces different levels of alarm depending upon the temperature measurements received from thetemperature measuring devices81. For example, as the temperature drops below or rises above successive preselected values of temperature, as measured by anytemperature measuring device81, thealarm device86 may sound successive predetermined alarm pitches, sounds, messages or series of sounds. Similarly, as the temperature measured by multipletemperature measuring devices81 successively falls below or rises above a preselected temperature, thealarm device86 may sound successive predetermined alarm pitches, sounds, messages or series of sounds. Thealarm system82 may also be connected to thevacuum supply50, so that upon production of a predetermined alarm by thealarm device86, thevacuum pump controller52 causes thepump51 to cease operation.

The computer ordata processor85 may also be connected to a temperature display andrecording device83 that records the temperatures measured by one or more of thetemperature measuring devices81. Thetemperature recording device83 may be any device designed to record or display data that is compatible with the signals produced by the computer ordata processor85. Such devices are preferably devices that record data on compact disks, floppy disks, magnetic tape, integrated circuits, or other similar media in digital form or “manual” devices that record or display data in a visually depicted form, such as a chart recorder or visual electronic display, such as an LCD or CRT monitor. The more preferred temperature display andrecording device83 is a device recording data on a compact disk used in conjunction with an LCD monitor.

It should be noted that in this embodiment of this version of the invention thecover40 may be of any configuration, including the cover configuration illustrated inFIG. 3 and the other cover configurations specifically discussed above in connection withFIG. 3. In addition, it is not necessary that any packing material ormatrix32 be present in the area of thewound25 beneath thecover40 in this version of the invention. It is also not necessary that the temperature display andrecording device83 be included in every embodiment of this version of the invention. Nor is it necessary that the features included in this version of the invention be included as a part of any other version or embodiment of this invention.

In another version of the invention, thewound treatment apparatus220 is portable and may be self-contained. In a first embodiment of this version of the invention, as illustrated inFIG. 8a, a miniature andportable vacuum source250 is connected to a wound cover. Thevacuum source250 is preferably a miniature and portable vacuum pump. Thevacuum source250 may also be connected to afilter253, which is connected to acollection system270. Thevacuum source250 is used to provide suction to the reduced pressure appliance, generally designated as230. It is portable in the sense that it is of a size small enough to be positioned directly on the surface of thewound cover240. Thevacuum source250 is also lightweight to avoid placing too much pressure on any body part being treated by theapparatus220 and to allow theapparatus220 to be easily transported. Thevacuum source250 may be powered by electricity received through a cord plugged into a standard wall socket, or thevacuum source250 may be powered by a battery, fuel cell, or other alternative means, such as solar or photo electric sells or a windmill or watermill operated generator. Thevacuum source250 may also be operated by other means, such as pneumatics or hydraulics, if such means are available.

Thewound cover240 may be of almost any size, shape, and configuration adapted to treat the wound. Thus, thewound cover240 is not limited to the embodiment illustrated inFIG. 8a. As illustrated and discussed above in relation toFIG. 3, the cover may be comprised of a rigid, fluid impermeable, cone-shaped, bowl-shaped, or cup-shaped wound cover to protect the site of awound25 from impact or abrasion during treatment. Alternatively, the cover may be comprised of a flexible or rigid flat wound cover.

Thevacuum source250 may be attached to thecover240 using any means that is compatible with the structure of thecover240 and thevacuum source250. For example, if thecover240 is constructed of a flexible, fluid impermeable material, thevacuum source250 may be attached to thecover240 using an adhesive material, such as a glue or other liquid or sprayed adhesive, adhesive tape, and similar means that are currently known in the relevant art or which may hereafter be discovered. As another example, if thewound cover240 is constructed of a rigid material, thevacuum source250 may be attached to thecover240 using a variety of fasteners and similar means, such as anchors, bolts, rivets, screws, nuts, latch and clasp, hook and loop fasteners (such as that commonly sold under the trade name VELCRO), ultrasonic welding, and similar structures that are currently known in the relevant art or which may hereafter be discovered. Thevacuum source250 may therefore be permanently attached to thecover240, or thevacuum source250 may be removably attached to thecover240 allowing thevacuum source250 to be reused after being used for a treatment even if thecover240 is no longer usable after such treatment. The means of fastening thevacuum source250 to thecover240 must, however, be accomplished in a manner that allows thecover240 to maintain the desired reduced pressure beneath thecover240 while it is in use. Thus, gasket or sealant material may be used to seal any areas of perforation of thecover240 where the fastener penetrates the surface of thecover240.

Thefluid collection system270 in the embodiment illustrated inFIG. 8aincludes acontainer271 to collect the exudate and a shutoff mechanism275, one embodiment of which is illustrated inFIG. 8b, to halt operation of thevacuum source250 if the level of exudate in thecontainer271 exceeds a predetermined level. Thecontainer271 is of the minimum size desired to collect and maintain the amount of exudate expected to be aspirated from the wound during the time of anticipated use of the portablewound treatment apparatus220. Alternatively, asmall container271 may be used, in which the fluid is changed intermittently as necessary during the treatment period. Thecontainer271 has two ports, afirst port272 for connecting thecontainer271 to the reducedpressure appliance230 and asecond port273 for connecting thecontainer271 to thevacuum source250. Afilter253 may also be connected intermediate thevacuum source250 and thecontainer271. The shutoff mechanism may be comprised of any means that enables thevacuum system250 to halt the supply of reduced pressure to thewound cover240 at any time the volume of exudate from the wound exceeds a predetermined amount to prevent, thereby preventing such exudate from contaminating thevacuum source250. Such means may include mechanical switches, electrical switches operably connected to thevacuum source250, optical, thermal or weight sensors operably connected to thevacuum source250, and any other means that are currently known in the relevant art or which may hereafter be discovered. Where the shutoff mechanism transfers electrical or other data signals to thevacuum source250, thevacuum source250 may contain a control mechanism to convert said signals to the form necessary to halt the production of reduced pressure by thevacuum source250. Such means is preferably the float valve shutoff mechanism275 illustrated inFIG. 8b, connected to thesecond port273 of thecontainer271, which has the same features as the float valve illustrated in and discussed above in connection withFIG. 4a.

As illustrated inFIG. 8a, this embodiment of the invention may also include afilter253 to prevent potentially pathogenic microbes or aerosols from contaminating thevacuum source250. Thefilter253 is generally comprised of a filter element encased in a fluid impermeable housing that has aninlet port256 and anoutlet port257. The filter element is preferably a hydrophobic and micropore filter capable of filtering out pathogenic microbes or aerosols. The housing of thefilter253 may be constructed in a manner that enables the filter element to be changed if desired. Thefilter253 need not, however, be used in every embodiment of this version of the invention.

In the embodiment illustrated inFIG. 8a,tubing245 is used to connect the reducedpressure appliance230 covering a wound225 to thecollection system270 by means of thefirst port272 located on thecontainer271. The features of thistubing245 and reducedpressure appliance230 are substantially the same as illustrated and discussed above in connection withFIG. 1 andFIG. 4a. In addition, in the embodiment of the invention illustrated inFIG. 8a, thesecond port273 of thecontainer271 is connected to theinlet port256 of thefilter253 byflexible vacuum tubing254, such as that used to connect thecollection system270 to the reducedpressure appliance230. This is not, however, the only means of connecting thecollection system270 to thefilter253. For example, the connection may be made by using a rigid, fluid impermeable structure, such as a short length of rigid polymer tube, permanently connecting thefilter253 and thecollection system270. Thefilter253 may also be directly attached to thecontainer271 without the use of any tubing or other means, causing thecontainer271 and thefilter253 to be integrated as a single unit. In the embodiment of the invention illustrated inFIG. 8a, theoutlet port257 of thefilter253 is connected to thevacuum source250 byflexible vacuum tubing254a, such as that used to connect thecollection system270 to the reducedpressure appliance230. This is not, however, the only means of connecting thecollection system270 to thefilter253. For example, the connection may be made by using a rigid, fluid impermeable structure, such as a short length of rigid polymer tube permanently connecting thefilter253 and thevacuum source250. Thefilter253 may also be directly attached to thevacuum source250 without the use of any tubing or other means, causing thecontainer271 and thefilter253 to be integrated as a single unit. As illustrated inFIG. 8a, thevacuum source250, thefilter253, and thecontainer271 may also be directly attached to one another to form a single integrated unit. Such attachment may be made by any of the means described above that may be used to attach thevacuum source250 to thecover240.

Use of the wound treatment apparatus can be illustrated by a prospective example involving a reducedpressure appliance30 of the type discussed in connection withFIG. 1. After preparing the bed of thewound25, one end of a length ofvacuum tubing45 is embedded in anabsorbable matrix32 that is trimmed to be the size and shape of thewound25. Thematrix32 is saturated with saline and placed in thewound25. As illustrated inFIG. 7, if temperature monitoring is desired,temperature measuring devices81 are placed in the desired locations and connected to analarm system82, and if desired, a display andrecording device83. Alternatively, a temperaturesensitive layer80 is placed over the matrix, as illustrated inFIG. 6. A fluid impermeable or gas impermeable flexibleadhesive sheet40, such as IOBAN, is placed over the matrix32 (and temperature measuring means, if utilized) and thewound25 and sealed to thenormal skin24 surrounding thewound25. The site of feedthrough of thevacuum tube45 and anyleads84 from under thecover40 is then sealed with a liquid or paste adhesive. Negative pressure is then applied to the reducedpressure appliance30 by thevacuum system50, through the intermediatefluid collection system70.

Negative pressure appliances are useful for treating a variety of wounds. Treatment of a wound can be carried out by securing a negative pressure appliance to the treatment site as previously shown and described, and then maintaining a substantially continuous or cyclical reduced pressure within the appliance until the wound has reached a desired improved condition. A selected state of improved condition may include formation of granulation tissue sufficient for the attachment of a flap or graft, reduction of microbial infection in the wound, arrest or reversal of burn penetration, closure of the wound, integration of a flap or graft with the underlying wounded tissue, complete healing of the wound, or other stages of improvement or healing appropriate to a given type of wound or wound complex.

It may be preferable to change the appliance periodically during treatment, particularly when using appliances incorporating a packing material on or in the wound. The time between changing the appliance where an absorbable matrix is placed on or in the wound would ordinarily be a greater time interval that is generally dependent upon the nature of the wound. Where it is necessary to change the absorbable matrix during the treatment period, it may also be necessary to remove a portion of the matrix, but leave in place the portion of the matrix into which there has been significant tissue growth. In such cases, the portion of the matrix without significant tissue growth incorporated therein should be carefully removed by cutting or tearing away such portion from the remaining portion. New absorbable material can be placed in the area from which the prior material has been removed.

The wound treatment apparatus is preferably operated using a negative or reduced pressure ranging from 0.01 to 0.99 atmospheres, and more preferably practiced using a negative or reduced pressure ranging between 0.5 to 0.8 atmospheres. The time period for use of the wound treatment apparatus on a wound may preferably be at least 12 hours, but can be, for example, extended for one or more days. There is no upper limit beyond which use of the wound treatment apparatus is no longer beneficial; use of the wound treatment apparatus increases the rate of closure up to the time the wound actually closes. Satisfactory treatment of various types of wounds has been obtained via the use of reduced pressures equivalent to about 2 to 7 in. Hg below atmospheric pressure.

Supplying reduced pressure to the appliance in an intermittent or cyclic manner has also been demonstrated to be useful for treating wounds. Intermittent or cyclic supply of reduced pressure to an appliance may be achieved by manual or automatic control of thevacuum system50. A cycle ratio, the ratio of “on” time to “off” time, in such an intermittent reduced pressure treatment may be as low as 1:10 or as high as 10:1. The preferred ratio is approximately 1:1 which is usually accomplished in alternating 5 minute intervals of reduced pressure supply and non-supply.

Asuitable vacuum system50 includes any suction pump capable of providing at least 0.1 pounds of suction to the wound, and preferably up to three pounds suction, and most preferably up to fourteen (14) pounds suction. The pump can be any ordinary suction pump suitable for medical purposes that is capable of providing the necessary suction. The dimension of the tubing interconnecting the pump and the reduced pressure appliance is controlled by the pump's ability to provide the suction level needed for operation. A ¼ inch diameter tube may be suitable.

In treating damaged tissue, use of the invention usually comprises the steps of applying negative pressure to a wound for a selected time and at a selected magnitude sufficient to reduce bacterial density in the wound. Open wounds are almost always contaminated with harmful bacteria. The application of negative pressure to a wound appears to reduce the bacterial density of the wound. It is believed that this effect is due to either the bacteria's incompatibility with a negative pressure environment or the increased blood flow to the wound area, as blood brings with it cells and enzymes to destroy the bacteria.

Burns may generally be treated using a method that comprises the steps of applying negative pressure to the burn over an area with predetermined reduced pressure and for a time sufficient to inhibit formation of a full thickness burn. A partial thickness burn, one which has a surface layer of dead tissue and an underlying zone of stasis, is often sufficiently infected so that it will transform within 24-48 hours into a full thickness burn, one in which all epidermal structures are destroyed. The application of negative pressure to the wound prevents the infection from becoming sufficiently severe to cause destruction of the underlying epidermal structures. The magnitude, pattern, and duration of pressure application can vary with the individual wound.

Claims (93)

What is claimed is:

1. An apparatus for the treatment of a wound, comprising:

a flexible wound cover;

a container in direct contact with and in fluid communication with the wound cover, the container being configured to retain fluid from the wound;

a vacuum source in fluid communication with the container; and

a hydrophobic filter interposed between the container and the vacuum source.

2. The apparatus ofclaim 1, wherein at least the wound cover, the container and the filter are integrated into a single unit.

3. The apparatus ofclaim 2, wherein the vacuum source is removably attached to the wound cover.

4. The apparatus ofclaim 1, wherein the apparatus is self-contained and portable.

5. The apparatus ofclaim 1, further comprising a battery power source.

6. The apparatus ofclaim 1, wherein the filter is integrated into the container.

7. The apparatus ofclaim 1, further comprising a vacuum source shutoff mechanism responsive to the fluid level in the container.

8. The apparatus ofclaim 7, wherein the vacuum source further comprises a control mechanism responsive to a signal sent from the shutoff mechanism.

9. The apparatus ofclaim 1, further comprising a flexible padding under the cover.

10. The apparatus ofclaim 1, further comprising an adhesive material disposed on the cover so as to create a substantially fluid-tight seal to the skin surrounding the wound.

11. The apparatus ofclaim 1, further comprising a porous screen disposed underneath the cover, the porous screen being constructed so as to permit the passage of fluids and gasses.

12. The apparatus ofclaim 1, further comprising a packing material underneath the cover.

13. The apparatus ofclaim 1, further comprising an absorbable material configured to be placed between the wound cover and the wound.

14. The apparatus ofclaim 1, wherein the wound cover is fluid-impermeable.

15. The apparatus ofclaim 1, wherein the cover further comprises a port in fluidic connection with the vacuum source.

16. The apparatus ofclaim 1, wherein the vacuum source is connected to the container via tubing.

17. The apparatus ofclaim 1, further comprising at least one monitor on or under the wound cover configured to monitor wound treatment.

18. The apparatus ofclaim 17, wherein the monitor is configured to monitor pressure beneath the wound cover.

19. The apparatus ofclaim 17, wherein the monitor is configured to monitor temperature in the area of the wound.

20. The apparatus ofclaim 17, comprising a plurality of monitors on the wound cover configured to provide a visual indication of the wound treatment.

21. The apparatus ofclaim 17, wherein the wound cover comprises a transparent or semi-transparent material to allow visualization through the wound cover.

22. The apparatus ofclaim 1, further comprising a shutoff mechanism configured to halt the supply of negative pressure to the wound cover.

23. The apparatus ofclaim 22, wherein the shutoff mechanism comprises an electrical switch operably connected to a vacuum system controller connected to the vacuum source.

24. The apparatus ofclaim 22, wherein the shutoff mechanism comprises an optical sensor operably connected to a vacuum system controller connected to the vacuum source.

25. An apparatus for the treatment of a wound, comprising:

a wound cover;

a fluid collector integrated with the wound cover and configured to be positioned with the wound cover over the wound, the fluid collector configured to retain fluid from the wound, wherein the fluid collector is in direct contact with the wound cover;

a vacuum source configured to provide suction to the wound beneath the wound cover; and

a filter intermediate the fluid collector and the vacuum source.

26. The apparatus ofclaim 25, wherein the wound cover comprises a flexible flat wound cover.

27. The apparatus ofclaim 25, wherein the wound cover comprises a rigid, fluid impermeable material.

28. The apparatus ofclaim 25, wherein the wound cover is cone-shaped, bowl-shaped or cup-shaped.

29. The apparatus ofclaim 25, wherein the fluid collector comprises a container attached to the wound cover.

30. The apparatus ofclaim 25, wherein the vacuum source comprises a portable vacuum pump.

31. The apparatus ofclaim 25, wherein the filter is a hydrophobic or micropore filter.

32. The apparatus ofclaim 25, wherein the wound cover, vacuum source, filter and fluid collector are integrated as a single unit directly attached to each other or the wound cover.

33. The apparatus ofclaim 25, further comprising an absorbable material configured to be positioned between the wound cover and the wound.

34. The apparatus ofclaim 25, further comprising at least one tube connected with the vacuum source configured to provide suction from the vacuum source to the wound.

35. The apparatus ofclaim 25, further comprising at least one monitor on or under the wound cover configured to monitor wound treatment.

36. The apparatus ofclaim 35, wherein the monitor is configured to monitor pressure beneath the wound cover.

37. The apparatus ofclaim 25, further comprising a shutoff mechanism configured to halt the supply of suction to the wound cover.

38. The apparatus ofclaim 37, wherein the shutoff mechanism comprises an electrical switch operably connected to a vacuum system controller connected to the vacuum source.

39. The apparatus ofclaim 37, wherein the shutoff mechanism comprises an optical sensor operably connected to a vacuum system controller connected to the vacuum source.

40. The apparatus ofclaim 25, further comprising a sealing ring secured to the wound cover.

41. The apparatus ofclaim 25, wherein the wound cover comprises a flexible polymer sheet.

42. An apparatus for the treatment of a wound, comprising:

a wound cover configured to be positioned over a wound; and

a vacuum source adjacent the wound cover configured to apply negative pressure to the wound, wherein the vacuum source and the wound cover form a single unit and the vacuum source is configured to be positioned with the wound cover over a patient,

wherein the wound cover defines a periphery and the vacuum source is located within the periphery of the wound cover.

43. The apparatus ofclaim 42, further comprising a fluid collector attached to the wound cover.

44. The apparatus ofclaim 43, further comprising a filter configured to prevent material from contaminating the vacuum source.

45. The apparatus ofclaim 44, wherein the vacuum source, filter and fluid collector form a single integrated unit configured to be positioned with the wound cover over the wound.

46. The apparatus ofclaim 42, wherein the vacuum source is in direct contact with the wound cover.

47. The apparatus ofclaim 46, wherein the vacuum source is attached to an outer surface of the wound cover.

48. The apparatus ofclaim 43, wherein the fluid collector is in direct contact with the wound cover.

49. The apparatus ofclaim 42, further comprising at least one monitor on or under the wound cover configured to monitor wound treatment.

50. The apparatus ofclaim 49, wherein the monitor is configured to monitor pressure beneath the wound cover.

51. The apparatus ofclaim 49, wherein the monitor is configured to monitor temperature in the area of the wound.

52. The apparatus ofclaim 49, comprising a plurality of monitors on the wound cover configured to provide a visual indication of the wound treatment.

53. The apparatus ofclaim 42, further comprising a shutoff mechanism configured to halt the supply of negative pressure to the wound cover.

54. The apparatus ofclaim 53, wherein the shutoff mechanism comprises an electrical switch operably connected to a vacuum system controller connected to the vacuum source.

55. The apparatus ofclaim 53, wherein the shutoff mechanism comprises an optical sensor operably connected to a vacuum system controller connected to the vacuum source.

56. The apparatus ofclaim 42, wherein the vacuum source is battery-powered.

57. The apparatus ofclaim 42, wherein the wound cover comprises a flexible sheet.

58. The apparatus ofclaim 42, wherein the wound cover comprises a rigid, fluid-impermeable material.

59. The apparatus ofclaim 42, further comprising a sealing ring secured to the wound cover.

60. The apparatus ofclaim 42, wherein the wound cover comprises a flexible sheet.

61. A method of treating a wound, comprising:

positioning a wound treatment apparatus comprising a wound cover and a fluid collector integrated with the wound cover over a wound;

applying negative pressure to the wound with a vacuum source to draw wound exudate into the fluid collector, wherein the fluid collector is in direct contact with the wound cover as negative pressure is being applied; and

retaining wound exudate within the fluid collector as the negative pressure is being applied with the fluid collector positioned over the wound.

62. The method ofclaim 61, further comprising sealing the wound cover to skin surrounding the wound.

63. The method ofclaim 61, further comprising powering the vacuum source with a battery.

64. The method ofclaim 61, further comprising shutting off the vacuum source if the fluid level in the fluid collector exceeds a predetermined amount.

65. The method ofclaim 61, wherein the negative pressure is applied to the wound through a filter between the fluid collector and the vacuum source.

66. The method ofclaim 61, wherein the wound exudate is drawn into a container attached to the wound cover.

67. The method ofclaim 61, wherein the fluid collector is positioned above the wound cover.

68. The method ofclaim 61, wherein negative pressure is applied to the wound through at least one tube between the vacuum source and the wound cover.

69. The method ofclaim 61, further comprising monitoring wound treatment with at least one monitor on the wound treatment apparatus.

70. The method ofclaim 61, wherein monitoring comprises monitoring the pressure beneath the wound cover.

71. The method ofclaim 61, further comprising ceasing the application of negative pressure in response to a shutoff mechanism responsive to the volume of exudate in the fluid collector exceeding a predetermined amount.

72. The method ofclaim 71, wherein the shutoff mechanism is an electrical switch operably connected to a vacuum system controller connected to the vacuum source.

73. The method ofclaim 71, wherein the shutoff mechanism is an optical sensor.

74. The method ofclaim 61, wherein the negative pressure is applied cyclically.

75. The method ofclaim 62, wherein sealing the wound cover comprises applying a sealing ring secured to the wound cover to a region of skin surrounding the wound.

76. An apparatus for the treatment of a wound, comprising:

a wound cover;

a fluid collector integrated with the wound cover and configured to be positioned with the wound cover over the wound, the fluid collector configured to retain fluid from the wound;

a vacuum source configured to provide suction to the wound beneath the wound cover, wherein the vacuum source comprises a portable vacuum pump, and wherein the vacuum pump is directly attached to the cover; and

a filter intermediate the fluid collector and the vacuum source.

77. A method of treating a wound, comprising:

positioning a wound treatment apparatus comprising a wound cover and a fluid collector integrated with the wound cover over a wound;

applying negative pressure to the wound with a vacuum source to draw wound exudate into the fluid collector, wherein the vacuum source is directly attached to the wound cover; and

retaining wound exudate within the fluid collector as the negative pressure is being applied with the fluid collector positioned over the wound.

78. A method of treating a wound, comprising:

positioning a wound treatment apparatus comprising a wound cover and a fluid collector integrated with the wound cover over a wound;

applying negative pressure to the wound with a vacuum source to draw wound exudate into the fluid collector;

retaining wound exudate within the fluid collector as the negative pressure is being applied with the fluid collector positioned over the wound; and

monitoring wound treatment with at least one monitor on the wound treatment apparatus, wherein monitoring comprises monitoring the temperature in the area of the wound.

79. A method of treating a wound, comprising:

positioning a wound treatment apparatus comprising a wound cover and a fluid collector integrated with the wound cover over a wound;

applying negative pressure to the wound with a vacuum source to draw wound exudate into the fluid collector;

retaining wound exudate within the fluid collector as the negative pressure is being applied with the fluid collector positioned over the wound; and

monitoring wound treatment with at least one monitor on the wound treatment apparatus, wherein monitoring the wound treatment is performed visually with a plurality of monitors on the wound cover.

80. An apparatus for the treatment of a wound, comprising:

a wound cover;

a fluid collector integrated with the wound cover and configured to be positioned with the wound cover over the wound, the fluid collector configured to retain fluid from the wound;

a vacuum source configured to provide suction to the wound beneath the wound cover;

a filter intermediate the fluid collector and the vacuum source; and

at least one monitor on or under the wound cover configured to monitor wound treatment, wherein the monitor is configured to monitor temperature in the area of the wound.

81. An apparatus for the treatment of a wound, comprising:

a wound cover;

a fluid collector integrated with the wound cover and configured to be positioned with the wound cover over the wound, the fluid collector configured to retain fluid from the wound;

a vacuum source configured to provide suction to the wound beneath the wound cover;

a filter intermediate the fluid collector and the vacuum source; and

a plurality of monitors on the wound cover configured to provide a visual indication of the wound treatment.

82. An apparatus for the treatment of a wound, comprising:

a wound cover;

a fluid collector integrated with the wound cover and configured to be positioned with the wound cover over the wound, the fluid collector configured to retain fluid from the wound;

a vacuum source configured to provide suction to the wound beneath the wound cover;

a filter intermediate the fluid collector and the vacuum source; and

at least one monitor on or under the wound cover configured to monitor wound treatment, wherein the wound cover comprises a transparent or semi-transparent material to allow visualization through the wound cover.

83. An apparatus for the treatment of a wound, comprising:

a wound cover;

a fluid collector integrated with the wound cover and configured to be positioned with the wound cover over the wound, the fluid collector configured to retain fluid from the wound;

a vacuum source configured to provide suction to the wound beneath the wound cover; and

a filter intermediate the fluid collector and the vacuum source;

wherein the wound cover defines a periphery and the fluid collector is located within the periphery of the wound cover.

84. The apparatus ofclaim 83, wherein the wound cover comprises a flexible polymer sheet.

85. The apparatus ofclaim 84, further comprising an adhesive on an underside of the wound cover.

86. The apparatus ofclaim 85, further comprising an adhesive strip configured to be positioned over at least a portion of the cover.

87. The apparatus ofclaim 83, further comprising a sealing ring secured to the wound cover.

88. The apparatus ofclaim 83, wherein the vacuum source comprises a portable, battery powered vacuum pump configured to be connected to the wound cover by at least one tube.

89. The apparatus ofclaim 83, wherein the filter is a hydrophobic or micropore filter.

90. The apparatus ofclaim 83, wherein the wound cover, filter and fluid collector are integrated as a single unit directly attached to each other or the wound cover.

91. The apparatus ofclaim 83, further comprising at least one monitor on or under the wound cover configured to monitor wound treatment.

92. The apparatus ofclaim 83, further comprising a plurality of monitors on the wound cover configured to provide a visual indication of the wound treatment.

93. The apparatus ofclaim 83, wherein the wound cover comprises a transparent or semi-transparent material to allow visualization through the wound cover.

Images